From the ANA Capital Update-They need YOUR Help And Support

RN Safe Staffing Act Reintroduced in U.S. House of Representatives

ANA-supported Safe Staffing legislation was reintroduced in the House of Representatives on March 2nd. Representatives Lois Capps (D-CA) and Steven LaTourette (R-OH) dropped the Registered Nurse Safe Staffing Act (H.R. 876), which would hold hospitals accountable for the development of valid, reliable unit-by-unit nurse staffing plans. These plans would be established by direct care registered nurses (RNs) in coordination with nursing leadership and based on each unit’s unique characteristics and needs. ANA needs your help to educate members of Congress and build support for this important legislation!

Insufficient nurse staffing is among the top concerns for nurses today. Accordingly, securing appropriate staffing to protect nurses and patients remains a lead priority for ANA. ANA supports the establishment of nurse-patient ratios to address the current crisis, but feels strongly that these ratios must be set, not by legislators, but in the workplace, in direct coordination with nurses themselves, and based on unit-by-unit circumstances and needs. This approach, based on ANA’s Principles for Nurse Staffing, treats direct-care nurses as more than just a number in a ratio. The RN Safe Staffing Act recognizes nurses as professionals and requires that they play an integral part of staffing plan development and decision-making by giving them a say in the care that they provide.

The Registered Nurse Safe Staffing Act would require Medicare participating hospitals, through a committee comprised of at least 55% direct care nurses or their representatives, establish and publicly report unit-by-unit staffing plans. These plans must:

• establish adjustable minimum numbers of RNs;
• include input from direct care RNs or their exclusive representatives;
• be based upon patient numbers and the variable intensity of care needed;
• take into account the level of education, training and experience of the RNs providing care;
• take into account the staffing levels and services provided by other health care personnel associated with nursing care;
• consider staffing levels recommended by specialty nursing organizations;
• take into account unit and facility level staffing, quality and patient outcome data and national comparisons as available;
• take into account other factors impacting the delivery of care, including unit geography and available technology;
• ensure that RNs are not forced to work in units where they are not trained or experienced.

While ANA respects all attempts to address staffing, we have real concerns about the establishment and legislation of fixed nurse to patient ratio numbers in federal or state legislation. Such legislated numerical ratios seem to offer a concrete solution, and may appear to be a good fit for some workplaces, however, so many other variables—factors including intensity of patient care needed, level of experience of nursing staff, layout of the unit, level of ancillary support—are key to establishing the “right” nurse-patient ratio for any one unit.

Regardless of the approach taken, no staffing system or ratio can protect patients and nurses without transparency and enforcement. The RN Safe Staffing Act requires public reporting of staffing information–hospitals would be required to post daily the number of licensed and unlicensed staff providing direct patient care on each unit and each shift, while specifically noting the number of RNs, and data must also be reported the Secretary of Health and Human Services (HHS) for publication on the Department’s Hospital Compare Website. The bill also requires collection and public reporting of quality data related to nursing services.

The bill affords whistle-blower protections for RNs and others who may file a complaint regarding staffing, allowing for refusal of assignment and establishing procedures for receiving and investigating complaints. Hospitals would be held accountable under the RN Safe Staffing Act through enforcement mechanisms including civil monetary penalties that can be imposed by the Secretary of Health and Human Services for each knowing staffing violation, as well as penalties for failure to collect and publicly report staffing and nursing-sensitive indicator data.

We need your help to build support for the RN Safe Staffing Act! Get more staffing information on ANA’s safe staffing website,http://www.safestaffingsaveslives.org/ or jump straight into action by writing your members of Congress or sharing your story through our Take Action page.

Michelle Artz and Rachel Conant